Have you self harmed?

One of the things I dislike in therapy is when a psychologist asks how many times I’ve self harmed that week. Okay, I can kinda see how it’s relevant to gauge whether I’m still self harming or not. From their point of view, it means I’m still engaging in risky, self-destructive behaviours and therefore is an issue that still needs to be worked on. But at the same time, is it really that helpful to put so much focus into it? In my mind, it reinforces the belief that the only way to communicate how I’m feeling on the inside is to physically harm myself on the outside.

A topic that has come up in my appointments with D is rejection; how much  fear it, how much it upsets me, how much I try to avoid it. There is a fear within me that if I report I haven’t self harmed, the professionals will automatically assume everything’s okay. I am afraid of rejection and I am afraid that I will be told at one point or another that I don’t need to continue seeing them any more because I’m ‘cured’.

There’s been a few times D has asked me to record down when I’ve self harmed during the week for homework. I’ve never done what he’s asked. I don’t believe it will do me much good and may even trigger me more by making me think I have to self harm to prove I deserve help.

YRS phone call & no BPD = no DBT

It’s odd when an interview to determine appropriateness for a particular service seems a bit like a job interview. It almost feels as though you have to sell yourself a certain way in order for them to accept you into their service. “What do you think you need help with?” Ummm…. “What would you want to work on the most?” Err…I dunno! Good thing it’s not a job interview, I wouldn’t be in with half a chance otherwise. The woman on the other end of the line at YRS (youth mental health service) told me she had looked up my health records and noticed I’d been referred for DBT. I confirmed yes, the psychiatrist at the psych ward had recommended I do DBT and thus the psychiatrist I was seeing at the time referred me to the DBT program a year ago. She said she’d ring A St (DBT place) to find out my position on the wait list, discuss with the team whether their service are able to accept me or not, and ring me back probably on Friday.

That same day in the afternoon I had an appointment with D. I told him of the outcome, in which the lady will contact A St and get back to me. D told me he was aware of the referral, but wasn’t sure DBT would be the best treatment for me though some of the skills could be useful. “Have you heard of something called Borderline Personality Disorder?” he asked me. I told him that I have. “Has anyone ever told you you have Borderline Personality Disorder?” I shook my head no. He told me he “doesn’t think I have it.” I couldn’t help feeling relieved and a little pleased upon hearing that. Though he also said it probably means I’m not eligible for DBT as they require a BPD diagnosis for admission into the program. No DBT for me? Gee what a pity… Can’t say I’m all that disappointed to be honest.

Shorts

It’s great when I don’t even have to think of an excuse for the scars I have from self harming. Instead, people come up with them for me! “Did you burn yourself with an iron?” my auntie asked me of the couple of scars on my arm, before she found out about my mentalness. Taken by surprise, I gave a vague “mmmmm” in response. More recently in Indonesia, I was again questioned on my scars. This time by my uncle, asking if I got burnt by a frying pan. “Nope, by an iron,” I told him, using my auntie’s ready made explanation.

When I was in the private mental health unit in May, I met another patient who was about the same age as me. She had scars all up and down both arms yet she still wears t-shirts and singlet tops same as everybody else. We got talking about self harm and scars one day. “People aren’t actually that bad,” she told me. “There was one person who stared,” she said, “But other than that most people are fine.”

The two coupled together, and I think I may be a little bit braver. This summer season I bought shorts.  Prior to this season, last time I did was way back in 2008. And as long as I don’t have recent wounds on the show, I wear them too. The shorter ones I only wear with stockings. The slightly longer one I wear by itself. It covers most scars when I’m stood upright, but rides up to reveal scars when I’m sat down. I think I’m okay with that. Others don’t have to be. I’ll never be able to wear the denim underwear that is so popular with 15 year old girls these days. But then again, why would I want to? I’m just happy to be back out in non knee-length shorts, the first time in about three years.

Put off therapy and mental health professionals

“Maybe being alone and not caring is better than to risk getting hurt,” was the theory I posed to D, the hospital psychologist. He calls this avoidance. I call it protecting myself. “But you want to have relationships,” he pointed out, referring to the list I had written while in hospital naming what the ideal would be if I didn’t have my problems. I shrugged at him. Maybe I’ve changed my mind.

I didn’t want to see D today. Not when I’d taken a break for about a month and it almost felt like starting all over again with someone new. Not after the whole fiasco with Dr T which has put me off mental health professionals altogether. I was fighting the urge to burst into tears or get up and walk out the door during the whole session. Fortunately I did neither. Not least because then I may have to explain why, and I wanted to avoid getting into the whole issue with Dr T. Not that staying there was all that much better. I didn’t quite have the courage to tell him I don’t want to do therapy any more. And so I glanced around the room in silence, hoping he’d get the hint. It’s worked before. It’s been at about this point that I had ceased with my previous two psychologists, when we’d run out of things to talk about.

I can’t help judging my current situation based on previous experiences. And my previous experiences have hammered into my head that therapy won’t work, we’re going to hit a brick wall, and it’s going to end by us parting ways not on a good note. I’m even less inclined to keep on and accept help after Dr T dropped me like that. What’s to say others won’t simply do the same? Rejection hurts. Knowing treatment has failed yet again hurts.

Despite this, I’ve still agreed to an appointment next week to see D. Sigh.

Peeved at now ex-pdoc

I’m pissed off. I think I have a reason to be too. You would think if a psychiatrist dropped you as a patient, you’d at least be notified and told your appointment has been cancelled. But no.

I had suspected this was the case when my GP told me Dr T had suggested I’d do better at A St Clinic instead of seeing just one private psychiatrist. Also, when I asked, the hospital psychologist told me he got the impression Dr T wouldn’t be seeing me any more. But still, no one had told me outright.

I had previously had an appointment scheduled with Dr T for this Friday. Nobody had told me it was cancelled. Not my GP, not Dr T’s secretary… And so I called up today intending to cancel for the last time. I asked the secretary whether I was meant to have an appointment for this Friday. She took a moment to check the appointment book. “No, you don’t,” she informed me. “Okay then, thanks,” I replied, and quickly hung up. That’s humiliating. I’m embarrassed I called up only to find out I’ve been unceremoniously dropped. Then again, it’s lucky I did call. Turning up would’ve multiplied the humiliation factor by 1000. I should’ve just not turned up without calling. Surely they can’t charge a cancellation fee when you’re not even a patient any more? Actually what I should’ve done is followed my instinct the first time I met her and looked for a different psychiatrist then and there.

Mental illness in Indonesia

As much as I moan about the mental health system in Australia, it could be worse. I mean, I could’ve ended up living here in Indonesia instead, where I’m currently holidaying and visiting relatives. Would’ve, had my grandparents not decided to relocate the family to Australia over 20 years ago.

Of course, I don’t have any direct experience, nor much knowledge of the mental health system here. But judging by the situation described in this video, it’s nothing to be proud of. Even those who are anti psychiatry must admit that’s better than chaining people up with nothing but a bare floor and open sewer, with only ancient wisdom, prayer and herbal therapy as treatment. It makes public psych wards in Australia look like five star hotels.

Then there’s the beliefs held by a proportion of the people here. My aunt’s friend’s daughter has some mental health issues. She’s been to a doctor and attends counselling. Her relatives though believe that her issues are caused by black magic; someone wanting to harm her or the family. They’ve recommended she see a healer who will extinguish the supposed black magic. It’s a notion that sounds bizarre to most of us living in the western world. There are many possible causes of mental illness, whether it be trauma, stress, biological, abuse, etc etc. But what we do know is that black magic is not one of them. A belief that is not firmly held here. It isn’t the families’ fault though. There are cultural differences and a lack of mental health literacy and education and awareness programs.

I feel both lucky and guilty. Guilty when I read and hear about how people with mental illness are mistreated here. Guilty when I reflect on my life in comparison. Such states of poverty in this country; homeless people, dwellings in which naming them ‘houses’ would be generous, hard manual labour in which their wages in a day we’d easily earn in an hour. What right do I have to be depressed in my first world conditions and to receive competitively good mental health care? I admit that when I arrive home I’ll be relieved; relieved I receive the standard of mental health care there instead of here, relieved that I’m not reminded and guilt ridden everyday of how privileged I am, relieved I live in Australia instead of Indonesia or some other developing country.

TWIM Awards & 2011 Stats

I am very much delighted and honoured to have won a TWIM Award again, this year in the Best Mood Disorder Blog category, especially amongst so many wonderfully written blogs in the Madosphere. So thank you very much to all those who voted for Behind the Facade and congrats to all the other winners!

 

And because I have nothing better to post it’s so, umm, interesting…here is my stats summary for 2011. According to the report, this blog was viewed 38 000 times last year with the busiest day being December 6th with 291 views. To other bigger and better blogs, the numbers are probably nothing, but for my humble blog, I’m rather impressed! Oddly, or not, most viewers were from the UK, despite me living in Australia. I guess this reflects how outnumbered I am in terms of where Madosphere members are located in the world!

Thanks to the top commenters listed in the report, and thanks to all who read my blog, whether you comment or lurk